- Ask your kidney doctor if you can visit a dialysis center. Visiting the center can help you make choices.
- If you are interested in a transplant, ask your doctor for a referral to a transplant center. Set up an appointment to visit with the staff and make a list of questions to ask.
- Speak to others who have been through the same experience.
- Discuss all your concerns with the healthcare team at the treatment center.
- Call your local National Kidney Foundation for information and a list of the programs and services available. Find out your local NKF office by visiting the NKF website at www.kidney.org. The National Kidney Foundation has a patient hotline for people affected by kidney disease, organ donation or transplantation. It's dedicated to patients, family members and caregivers. Call toll-free at 1-855-NKF-Cares (653-2273) to speak with a trained professional who will answer your questions and listen to your concerns.
Kidney Failure (Acute Kidney Failure)
Acute kidney failure happens when your kidneys lose their ability to rid your body of waste, excess fluid and salts. When your kidneys no longer filter properly, the fluids, salts and wastes accumulate in your body. Acute kidney failure develops quickly, within hours or days. Signs can include urinating less, swelling in your legs, ankles or feet because of the fluid you're retaining, drowsiness, shortness of breath and fatigue. You are most at risk of acute kidney failure if you are hospitalized with another serious problem that requires intensive care. Other risk factors include being elderly, having diabetes, high blood pressure, heart failure and liver disease. Acute kidney failure can be fatal. However, it can be successfully treated with drugs and dialysis.
1 AnswerIt is normal to have concerns about how you will feel, whether the treatment will hurt, what your relationship with the staff and other patients will be like, and how long you can live with the disease. The following steps can help you cope with your feelings:
1 AnswerYou and your family may have difficulty accepting the changes in your lives caused by kidney failure, which can be a lot to handle. You may have feelings of frustration, guilt, denial, anger and depression. You and your family may find it helpful to share your questions and concerns with each other and with people who are willing to offer support. These can include close friends and members of the healthcare team. The social worker at your dialysis center is trained to provide counseling to help you make the transition to dialysis or transplantation.
Some of the biggest adjustments are:
- getting used to a new routine with peritoneal dialysis or hemodialysis
- following your diet and nutrition plan
- taking all your medications exactly as ordered by your doctor (including anti-rejection medications if you have a transplant)
- continuing with your work, studies, family commitments and hobbies
1 AnswerMedicare may pay up to 80% of the costs associated with dialysis and kidney transplant. But Medicare alone is not enough. Many other sources of coverage are available to help pay for what Medicare does not cover, including:
- employer health insurance, private health insurance, COBRA
- state programs such as Medicaid and high-risk insurance pools
- veteran’s benefits
- state kidney programs
- Medigap (Medicare supplemental health insurance)
- your state insurance commissioner and ask what options are available to you where you live
- an independent insurance broker
- the National Kidney Foundation (NKF) at 1-855-NKF-CARES (653-2273) (toll-free), or your local NKF office
- a financial aid coordinator at your dialysis center or transplant center
- your county or state social service department or Medicaid office
1 AnswerMedicare will begin to cover dialysis treatments or a kidney transplant when:
- You start your fourth full month of in-center hemodialysis.
- You start a home dialysis training course at a Medicare-approved facility within the first three months of treatment, and you plan to do home dialysis.
- You are admitted to a Medicare-approved hospital for a transplant, or up to two months before admittance if pre-transplant health care and testing are begun.
- You are already on Medicare.
1 AnswerMany of the costs of dialysis and kidney transplantation are covered by the federal government through Medicare. Medicare is not just for people who are 65 and older. The program also helps Americans and legal residents of all ages who need dialysis or a kidney transplant and qualify for coverage.
People with kidney failure can enroll in Medicare at their local Social Security office. Before signing up, your dialysis clinic or transplant program must complete a form and have it signed by your doctor verifying you have started dialysis or received a kidney transplant. To find your local office, look for Social Security Administration or go to www.ssa.gov.
1 AnswerExercise can help you feel stronger and improve your overall well-being when you are being treated for kidney failure. Walking is good way to exercise. You should speak to your doctor about an exercise program that is right for you.
1 AnswerYou may need to take special medications when undergoing treatment for kidney failure. These include:
- Phosphate binders. These medications keep your bones strong by helping your body keep the right balance of two important minerals, calcium and phosphorus.
- A special prescription form of vitamin D. This medication also helps to keep your bones healthy.
- Drugs called ESAs (erythropoiesis-stimulating agents). ESAs act like a natural hormone made by your kidneys called erythropoietin. This hormone tells your body to make red blood cells. Not having enough of it can cause anemia (low red blood cell count). Treatment with an ESA can help your body make red blood cells.
- Extra iron. Your body also needs iron to make red blood cells, especially if you are receiving ESAs. Without enough iron, your ESA treatment will not work as well.
- Vitamin and mineral supplements. You may need to replace certain vitamins and minerals that you are not getting in your diet or that are lost during dialysis. Your doctor and dietitian will tell you which ones you need to take.
- You may need to take other medications depending on your own medical needs. These could be medications to control high blood pressure, high cholesterol or diabetes.
- If you have a transplant, you may also need to take anti-rejection medications. These medications help to keep your body from rejecting the new kidney.
1 AnswerIf you start on one type of treatment for kidney failure but feel you would like to try something else, you can speak to your healthcare professional about the possibility of changing. For example, if you choose hemodialysis, it doesn't mean you can't ask to switch to peritoneal dialysis at a later date. Even if you choose to have a kidney transplant, you may need a period of dialysis until you can be transplanted with a new kidney. It is not uncommon for people who have had kidney failure for many years to have had more than one type of treatment in that time.
1 AnswerThe two treatments for kidney failure are dialysis and kidney transplantation. Two different kinds of dialysis can be done -- hemodialysis and peritoneal dialysis. Each type of treatment has pros and cons. Speaking with your doctor and your family can help you make a decision about the treatment that is best for you. The decision will be based on a number of factors, including your:
- medical condition
- personal preference
- following your treatment schedule
- following your special diet
- taking all the medications prescribed for you
1 AnswerThe kidneys filter wastes from the blood and remove excess water from the body via urine. When the kidneys aren’t doing their job, this fluid can stay in the system instead of being excreted. Swelling around the hands, feet and ankles may be associated with kidney or heart failure and shouldn’t be dismissed.